Prevention · 4 min
Five biomarkers worth caring about
A standard annual blood test will tell you whether you are sick today. It will rarely tell you whether you are quietly building disease for tomorrow. These five markers shift that horizon by years — sometimes decades.
1. ApoB
Counts the atherogenic particles directly. Targets: <80 mg/dL low risk, <60 mg/dL high risk. Repeat annually or every 3-6 months to evaluate interventions.
2. Fasting insulin (and HOMA-IR)
Catches insulin resistance years before glucose moves. Target fasting insulin <6 µIU/mL; HOMA-IR <1.5. Almost never ordered by default — ask for it.
3. hsCRP
A non-specific but powerful marker of vascular inflammation. Persistently >2 mg/L roughly doubles cardiovascular risk independent of cholesterol. If elevated, look for the source: dental disease, abdominal adiposity, autoimmune activity, poor sleep.
4. HbA1c
Three-month average glucose. Optimal <5.3%; pre-diabetic 5.7–6.4%. Useful, but always pair it with fasting insulin — HbA1c is a late marker.
5. Lp(a)
Genetically determined, measured once in a lifetime. Elevated in ~20% of people and a strong independent risk factor for cardiovascular disease and aortic stenosis. Targets are not yet standardised — anything >50 mg/dL (or >125 nmol/L) deserves attention.
What to ask for at your next blood draw
- ApoB, fasting insulin, HbA1c, hsCRP, and a one-time Lp(a).
- Add: fasting glucose, full lipid panel, ALT, ferritin, vitamin D, TSH, homocysteine.
- Bring the results to a clinician who treats them as a trajectory, not a snapshot.